Section 108.10  Resident Liability for Payment of Maintenance Charges

 

By law, each resident of an Illinois Veterans' Home shall be liable for the payment of maintenance charges for care at a rate to be determined by the Department based on the resident's  ability to pay, but not to exceed the average annual per capita cost of maintenance.

 

(Source:  Amended at 12 Ill. Reg. 4225, effective February 29, 1988)

 

Section 108.20  Allowances for Unusual Expenses

 

An Administrator, upon being furnished proof of payment or proof of indebtedness, may make allowances for unusual expenses in determining the ability of the resident to pay maintenance charges.  Admission of residents shall not be limited or conditioned in any manner by their financial status or their ability to pay the maintenance charges.  Refusal or failure to pay the established maintenance charges shall be cause for discharge of a resident from a Home.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.30  Investigation of Financial Condition of Residents

 

The Department is authorized to investigate the financial condition of residents of a Home to determine their ability to pay maintenance charges and to establish standards as a basis of judgment for such determination.

 

(Source:  Amended at 12 Ill. Reg. 4225, effective February 29, 1988)

 

Section 108.40  Filing of Financial Statements

 

a)         Annually, between January 1 and February 8 of each year, each resident or applicant shall file a sworn financial statement, on the appropriate form, on which shall be reported income from any and all sources  as well as assets. The resident or applicant shall also indicate responsibility for the support of any dependent which should be considered in fixing the amount of his (her) monthly charges.  When changes occur in a resident's income and/or assets, he (she) is required to complete a new financial statement.  If changes are undisclosed, upon discovery, monthly maintenance charges will be adjusted retroactively to the effective date of the income change.

 

b)         Since many of the residents of the Veterans Homes receive, in conjunction with their United States Department of Veterans Affairs (USDVA) pension, an extra monetary award, either Aid and Attendance or Housebound Benefits, this extra amount will be due and shall be collected by the Homes and then the monthly maintenance charge shall be based on the balance of the resident's total income.  The Aid and Attendance or Housebound Benefits from the USDVA shall be incorporated in the resident's total payment and shall be due on the first of each month and must be collected no later than the tenth day of each month.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.50  Income Used in Computing Maintenance Charge

 

a)         Income used in computing the maintenance charge shall include:

 

1)         Social Security benefits less the premium for Part B Medicare.

 

2)         Retirement benefits.

 

3)         Income from annuities.

 

4)         Insurance payment benefits.

 

5)         Rental from property.

 

6)         Farm income.

 

7)         Interest income earned from the resident's personal funds maintained in the Home's Trust Fund.

 

8)         Income from assets or other sources that would be reportable for income tax purposes.

 

9)         United States Department of Veterans Affairs pension or compensation (including widows' pensions).

 

b)         The only income that shall be excluded in computing the monthly maintenance charges shall be that which a resident receives as wages for "work therapy" programs at a Home.

 

c)         If a resident maintains an outside health insurance policy for his/herself, the amount of monthly premiums paid for the health insurance shall be substracted from the resident's gross income prior to calculating the maintenance fee.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.60  Rejection of Application or Discharge from Homes

 

Should it be determined that an applicant or resident has assigned assets within the past five (5) years to another individual to evade or reduce maintenance charges, such action may be a basis for rejection of the application or for discharge from a Home.

 

(Source:  Amended at 12 Ill. Reg. 4225, effective February 29, 1988)

 

Section 108.70  Allowance Based on Total Income

 

An allowance based on total income shall be made in computing a resident's monthly maintenance charge if it is necessary to contribute to the support of a legal dependent.   Legal dependents shall only be the mother, father, wife, husband, or minor child of a resident who by reason of insufficient financial resources must have such contributions in order to maintain themselves.  An older child who is totally incapacitated may also be recognized when dependent on the resident for support.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.80  Purchase of Personal Items

 

Residents shall, from that portion of their monthly income which is in excess of their maintenance charges, purchase all items for their personal comfort, including necessary clothing, non-prescribed medication and medication prescribed by a non-staff physician, but not available from the Home's drug supply.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.90  Due Date of Maintenance Charges

 

Maintenance charges are due the first of the month following the month of admission and each month following the month of admission and each month thereafter, and shall be paid in full for the month by the resident on or before the tenth day.  A resident may be permitted to pay the charge in quarterly or on some other advance basis if such arrangements are more satisfactory to him (her).  Maintenance charges will be assessed to a resident who enters a Home at any time during a month.  Assessment of the cost of maintenance charges for periods of less than one month's care shall be calculated beginning on the day of admission and shall include the number of days an individual is a resident.  Maintenance charges will be assessed to a resident who takes a leave of absence for a period of 30 days or less to guarantee reservation of the resident's living quarters upon his (her) return to the Home.  Maintenance charges will not be assessed to a resident who takes a leave of absence consisting of 31 days or more, and his (her) living quarters will not be reserved.  Refunds of maintenance charges upon death or discharge of a resident will be calculated by pro-rating the maintenance charges for the days of care provided during the month of death or discharge, and subtracting such amount, as well as any unpaid charges for which the resident was liable, from the resident's paid maintenance charges.  The resident's monthly Aid and Attendance payments are non-refundable.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.100  Liability of Conservator

 

If a resident is under a conservatorship, the conservator shall be liable for payment of the maintenance charge as determined for that resident.  If a resident is under an institutional award from the United States Department of Veterans Affairs (USDVA), the USDVA shall be liable for payment of that portion of the maintenance charge required to be collected from USDVA Funds for the account of that resident.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.110  Transmittal of Funds

 

Funds received as payment for maintenance charges shall be transmitted to the State Administrative Offices of the Illinois Department of Veterans' Affairs for deposit with the State Treasurer of the State of Illinois in each Veterans Home Fund respectively, in accordance with statutory provisions and established fiscal procedures.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.120  Failure to Pay Maintenance Charges

 

a)         When a resident is discharged for failure to pay the established maintenance charge, he (she) shall not be eligible for readmission to a Home until an exclusion period of three months has elapsed.

 

b)         A person who has been discharged by reason of non-payment of a maintenance charge may apply for readmission after the three-month period of exclusion. The former resident will be subject to the Home's established eligibility standards and waiting lists. Any indebtedness owed to the State of Illinois must be paid in full on the first day of readmission, or arrangements to pay such charges must be agreed to by the individual and the Administrator of a Home.

 

c)         A resident who voluntarily leaves a Home after the fifth day of the month shall not be eligible for readmission to a Home until such charges are paid in full, or arrangements to pay such charges are agreed to by the individual and the Administrator of a Home.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.130  Assessment of Maintenance Charges

 

a)         Maintenance charges for each resident of an Illinois Veterans Home shall be assessed at the rate of 90% of all income, but not exceeding the average annual per capita cost of maintenance as computed annually.

 

b)         Veteran and spouse, both at a Home, will each pay maintenance charges based upon one-half of their combined monthly income, and are each entitled to the monthly allowance amount.

 

c)         Monthly Allowance

Residents shall be entitled to a month allowance of $100/month for every $1000 in paid monthly maintenance charges.

 

EXAMPLE:  A $100 allowance will be provided to the resident (and qualifying resident spouse) for $.01 to $1000 in paid maintenance charges. A $200 allowance will be provided to the resident (and qualify resident spouse) for $1000.01 to $2000 in paid maintenance charges. A $300 allowance will be provided to the resident (and qualifying resident spouse) for $2000.01 to $3000 in paid maintenance charges; etc.

 

(Source:  Amended at 37 Ill. Reg. 12087, effective July 10, 2013)

 

Section 108.140  Deposit Requirements

 

a)         Whenever it is deemed necessary to health, order, safety, or general welfare of a resident, the Administrator may require the resident to deposit in a resident's trust fund at a Home such monies from any source of income as may be determined necessary, and disbursement of these funds to the resident shall be made only by direction of the Administrator.

b)         In case a resident has a dependent child, spouse, or parent, the Administrator may require that all monies received by the resident be deposited in the resident's trust fund with dependency contributions being made at the direction of the Administrator.  Any balance retained may be disbursed to the resident as needed by direction of the Administrator and shall be paid to the resident at the time of discharge or to the resident's estate after death of the resident.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.150  Allowable Unusual Expenses

 

a)         Allowable unusual expenses for which a maintenance charge reduction may be approved by the Administrator shall only be in these categories:

1)         Prosthetic, orthopedic, or paraplegic appliances.

2)         Sensory aids.

3)         Non-standard wheelchairs of special or custom construction or adaptation.

4)         Therapy services upon the recommendation of a staff physician.

5)         Hospital, medical, and surgical expenses in other than a United States Department of Veterans Affairs Hospital/Medical Center when recommended by a staff physician and approved by the Administrator.

6)         Funeral expenses for dependents.

b)         When the Administrator approves an allowance for an unusual expense, the resident's monthly maintenance charge shall be reduced by that allowance.  The amount of the allowance shall then be deducted from the resident's trust fund account and payment shall be made monthly from this account by a Home to the proper payee on behalf of the resident.  The allowance for an unusual expense can be a one-time allowance or an ongoing allowance.  If an allowance is approved for the support of a legal dependent, the sum the resident contributes shall be collected on or before the tenth day of each month, deposited in the resident's trust fund account, and payment made monthly from this account by a Home to the legal dependent on behalf of the resident.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.160  Claims Against the Residents' Estates

 

Maintenance charges unpaid upon the death of a resident or former resident shall constitute a claim against that resident's estate.  The Department shall file a claim for unpaid maintenance charges against the estate in accordance with procedures prescribed by the Uncollected State Claims Act [30 ILCS 205] and the Illinois State Collection Act of 1986 [30 ILCS 210].  Upon the death of a resident with a personal fund deposited with the Home, the Home management must convey within 30 days the resident's funds, and a final accounting of those funds, to the individual or probate jurisdiction administering the resident's estate.  Employees of an Illinois Veterans Home shall be prohibited from serving as the executor of a resident's estate.  The Administrator (or Executor) of the estate, the attorney for the estate and/or other agencies or persons holding assets of the deceased resident shall be notified of the Department's claim against the estate.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)

 

Section 108.170  Maintenance Charges for Member With Dependent

 

Each resident of a Home who receives a pension or compensation and who has dependents requiring his (her) support shall contribute a monthly dependency allowance based upon a court order.

 

(Source:  Amended at 25 Ill. Reg. 8841, effective June 29, 2001)